Has anybody on DU actually looked at the health insurance reform bills? There must be a

[sinkingfeeling]

dozen threads an hour on 'the mandate' and not a word about the subsidies that will go to people making up 400 percent of the poverty level. Both the Senate and House bills include the same thing.

http://www.nytimes.com/interactive/2009/11/19/us/politics/1119-plan-comparison.html?hp#tab=4


http://www.politico.com/static/PPM41_hcr_complete_summary.html


The House bill (which passed) is even better. It contains a limit on the out-of-pocket expenses an individual or family will hae to pay out, based on income.

Affordability credits. Provides financial assistance for premiums and cost sharing for individuals and families with incomes up to 400 percent of the federal poverty level (FPL). Affordability credits are offered on a sliding scale such that premiums range from 1.5 percent of income at the lowest tier to 12 percent at 400 percent FPL. Provides additional assistance for households with incomes up to 400 percent FPL by limiting cost-sharing to 3 percent of plan costs at the lowest tier rising to 30 percent of plan costs at 350-400 percent of FPL. Specific out-of-pocket maximums are added to protect individuals at each income tier.

Eligibility. Affordability credits are available to American citizens and legal residents whose employers do not offer coverage or whose share of employer-sponsored health insurance costs more than 12 percent of their family income. Those eligible for other government health care programs, such as Medicare or Medicaid, cannot receive affordability credits. Establishes a mechanism by which the Commissioner must verify that individuals are citizens or legal immigrants in order to receive affordability credits.

Medicaid and CHIP. Expands Medicaid coverage to everyone within income at or below 150 percent FPL ($33,100 per year for a family of 4) who is not eligible for Medicare. Eliminates assets tests for eligibility groups other than for long-term care. Requires States that now cover those above 150 percent FPL to maintain eligibility. States receive full federal funding for costs of expansion populations in 2013 and 2014. Thereafter, States pay 9 percent and the federal government pays 91 percent. CHIP-eligible children move to the Exchange or Medicaid in 2014.

[leftstreet]

1. I'm sure the Republicans will campaign on that positive note

They won't use !!MANDATES!! as a spin talking point

[rockymountaindem]

2. House bill = okay

Senate bill = a circus train wreck, engineered by clowns.

I guess I am one of the new converts against the reform process, thanks to the atrocious piece of legislation being ginned up in the Senate. Let the record show that I thought the House bill was worth passing and still is because it has out-of-pocket cost caps and other things the Senate bill lacks.

[madfloridian]

3. Those links are from Oct. and Nov.

Has there been much change since then?

[sinkingfeeling]

4. Absolutely none on the House bill. The Public Plan is gone from the Senate version.

[Phoebe Loosinhouse]

5. Even WITH subsidies, they are still unaffordable.

There is a thread around here somewhere with a chart from Nate Silver that shows a family of four with an income of 54K paying 9K in premiums and out of pockets WITH SUBSIDIES. Granted, that is better than without reform and without the subsidies(!), but that family will probably have to go without either way. In that case "reform" is an illusion. If all you have is 5K to buy a car with, what difference does it make if the government will subsidize you buying 15K car with a 5K rebate? You still can't buy the car. That is the point that is being made.

It's the same WTF moment when the Medicare buyin sounded so great, but then the fine print said WITHOUT SUBSIDY and it turned out to be 7200 a year PER PERSON!!! Again - thanks for nothing!

Starting to get it? It's all smoke and mirrors. I can't even pretend to know what they are thinking at this point except that they are all so wealthy and cocooned that they don't have even the merest shadow of a clue as to how the average American lives.

[sinkingfeeling]

10. That's not something from the House version. A family of 4 making $54K would have its

premiums capped at 8 to 10 percent of income = %5400 a year tops. Then they would have their out-of-pocket expenses capped at $8K (which is a lot, but that's the cap, not actual).

It would seem that you are asking for for totally free health care. If you make so little, then you and your family might qualify for the expanded Medicaid that's in the plan. Any family of 4 making below $33,100 a year, could get Medicaid.

By the way, $7200 a year for Medicare is probably less than the average current Medicare receipient pays. They all pay $96.40 a month for Part B ($1156.80 a year) and average cost of Part D is around $33 a month ($396/yr) and then most pay for supplemental coverage either via Medigap policies or Part C (Medicare Advantage), which can cost a couple of hundred or more a month. My 90 yr-old mom pays something close to $640 a month total. She also, like all Medicare folks, has co-pays.

[Phoebe Loosinhouse]

18. It is from the Senate version

and I quoted what was in the table for a family of four making 54K a year WITH subsidies. Your figures from the House version are actually worse.

Why not just assume the worst - that some families out there will have major disease, or accidents that will bring them right up to the caps. Given the cost of care, it won't be just a few, it will be many. Median household income in the US is around 50K.

I am not talking about my family specifically, although Medicare buy-in for a couple over fifty at 14,400 a year would be prohibitively expensive for Many if not most Americans. No, I don't want totally FREE healthcare , but it is obvious that the word "affordable" is subject to interpretation.

[seabeyond]

6. ah thank you. no didnt know. dont know to be angry or not or wtf. lol.

that was one of my questions.

[Cleita]

7. It's still lipstick on a pig and it will crash our economy if allowed to exist

as it is. It's not my prediction but that of those who have been close to the health care industry and know the rot that is sponsoring this bill.

[county worker]

8. Subsidies are tax credits.

You have to spend the money first.

If people cannot afford health insurance now, how is that going to change when the bill passes? Are we going to mail them a check for the money they spend on insurance?

Do they go to the grocery with some government subsidy voucher good for food or clothing or rent?

Is the insurance they can afford going to pay for the care they need or is there still going to be some out of pocket costs to them?

You wait, I am willing to bet that the only difference between now and when the bill passes and they get subsidies is that they will not only go without medical care, but also without as much food, clothing and rent.

This bill is not written with the intent of giving care to people but is rather written to give more people insurance coverage. Insurance coverage does not translate to medical care, not now nor in the future.

You want a good bill? Write a bill that states that medical care is a right and we all pay taxes to pay for care and not insurance.

[enlightenment]

11. They are suggesting that the insurance companies

will have to pay somewhere between 60 and 70% (depending on the bill version) of actuarial costs. How are they planning on figuring that actuarial cost? Age, gender, physical condition? It sounds suspiciously like they are going to allow annual caps in place of life-time caps - and at lower payout percentages than most insurance pays today.

A subsidy might offset the cost of the premium, but it won't pay the actual cost of care.

[Kitty Herder]

16. This. "A subsidy might offset the cost of the premium, but it won't pay the actual cost of care."

That's the core problem right there.

[sinkingfeeling]

Just a question, but if somebody can't pay $100 or $700 a month for health insurance, how can they

pay $100 or $700 a month more in taxes to pay for care?

[county worker]

13. Taxes are withheld from their paycheck.

So the taxes are withheld, then on top of that they pay insurance premiums. When they file a return they get a credit. The only thing to offset that is to lower the withholding to equal the credit. That is difficult to do because to do it you have to claim more exemptions than you really have. Chances are you will not have enough withheld and you will get a penalty for late payment if you can make a payment at all with the filing of your return.

If you don't pay taxes how do you get your insurance covered I wonder?

Instead of a subsidy why not give people vouchers for what ever health care they need? Why involve insurance companies? Insurance companies are not adding any value here.

[sinkingfeeling]

19. I honestly don't know what you're talking about. There are costs for health care. Who would pay for

it? If someone says they can't afford $100 a month for an insurance policy, how can they afford $100 in new taxes to pay for government health care? I don't think insurance companies will ever go away, since all government programs like Medicare and Tri-Care involve private insurance companies.

But you're asking for 'free' health care via voucher or whatever and not explaining how it would be paid for. There would have to be new taxes to pay for any type of 'single-payer' plan.

[Kitty Herder]

15. Have you ever heard of progressive taxation?

[sinkingfeeling]

12. Duplicate.

[readmoreoften]

9. The poor stabilized on the backs of the working class reaping profits for the rich few?

Nothing more but a pittance, insult, and opportunism.

[county worker]

14. Didn't you speak in Russia back the the early 1900's?

I think I heard that line in Reds. Not that it isn't a good one. Maybe we have a revolution in our future. Well probably not since we are willing to take any shit that they hand to us.

[EFerrari]

17. They're fixing to drop the FPL:

http://www.timesargus.com/article/20091215/NEWS01/912150361/1002/NEWS01